The Wild, Kind Of Crazy History Of Boob Jobs

It’s pretty amazing when you think about
it: The first medical report of a breast augmentation surgery occurred 120
years ago. That’s more than 65 years before the
silicone implant was invented!

In 1895 — to put that in perspective, Grover
Cleveland was President of the United States, and Oscar Wilde was hanging out
in a London prison — a German-Bohemian surgeon named
Vincenz Czerny documented what is believed to be the first breast-reconstruction
surgery, on a 41-year-old singer who was concerned about asymmetry after having
a tumor and much of the surrounding tissue removed from her left breast. As you
might imagine, though, today’s medical technologies and prostheses
were not available, so ol’ Vinny had to improvise.    

“Luckily, the lady had a lipoma, larger than a fist, in the
right lumbar region,” Czerny wrote in a translated case report. “I decided,
therefore, to use this for a reconstruction of the extirpated breast.”    

A lipoma is a fatty tumor. So, that’s right, folks:
Czerny used a patient’s own fatty tumor as an implant to
fill the space emptied by the removal of a different tumor. Creative,
right? 

Although the tumor-transfer method of breast augmentation didn’t
stick — not everyone has a convenient lipoma or two waiting to be
harvested, after all — it got the gears going for surgeons
and medical innovators who followed. Between the 1890s and 1960, no single
technique for breast augmentation and reconstruction had staying power, largely
because so many of the experimental methods — from
paraffin injections to glass balls to alcohol sponges — failed
miserably. Today, however, there are several medically sound
options.      

Breast Implants

Breast implants are not only the most popular form of breast-augmentation surgery, they’re the most popular cosmetic surgical
procedure overall, according to the American Society for Aesthetic Plastic Surgery's 2010 statistics (although that number might be surpassed soon by the Brazilian Butt Lift). However, even if you’ve decided to get implants, you
have an additional decision to make: what kind.    

Silicone-gel and saline-filled implants
were both introduced in the early 1960s. Although saline
implants were briefly the more popular of the two in the 1990s, when there
was a moratorium on silicone implants, dozens of studies
disproving a causal link between silicone implants and autoimmune illnesses
allowed them to return to the market in 2006 and consequently paved the way for encased
silicone gel to regain its status as the more popular implant material.    

This second wind of popularity is partly due to plastic surgeons
often preferring the results of silicone over that of saline.   

“I prefer silicone,” says
Jessica Suber, MD, plastic and reconstructive
surgeon at Southern Ohio Medical Center. “Though both will
generally provide the patient with the look they are aiming for, I believe
there is a more natural ‘feel’ to silicone implants. Most patients
end up choosing silicone after being educated on both and getting to hold and
squeeze the implants.”    

Material, however, isn’t the only decision a patient has to
make.

“Breast-augmentation options have definitely increased. There
is still the classic breast implant option, but even that has varied with the
new ‘shaped’ implants,” Dr.
Suber says, referring to devices like Allergan’s Natrelle 410 Highly Cohesive Anatomically Shaped
Silicone-Gel Filled Breast Implant, which received FDA approval in 2013. “These can be a
great option for someone who is looking for more breast fullness but with a
very natural slope, versus the round implant.”    

Dr. Suber doesn’t rely on medical
training alone for her opinions on breast implants.    

“I’m a big believer
in testing out products prior to offering them to my patients, and I am happy
to say I have breast implants myself,” Dr. Suber says, gladly putting to
rest any notion that someone should be embarrassed about their decision to
undergo this procedure. “It is definitely nice to be able to
relate to my patients who are interested in or recovering from the procedure. I
have been very satisfied with my decision, and highly recommend the procedure to
anyone who is interested and a candidate.”      

Fat Transfer

The term “breast augmentation” doesn’t
refer to implants alone. Another surgical option is autologous fat transfer, or
fat grafting, in which fat is removed via liposuction from one part of the
body, processed, and injected into the breasts.    

Although experiments like Czerny’s show that medical
professionals have been dabbling in fat transfer as a means of breast
augmentation for over a century, the procedure didn’t become mainstream
until very recently. In fact, in 1987, the American Society of Plastic Surgeons
placed a 20-year moratorium on performing fat-grafting procedures,
making implants the only augmentation option for decades.  

Today, however, it is recognized as both a low-risk procedure and
an exciting alternative to implants.    

“Harvesting your own fat and having it transferred to a
different area on your body can be a great option for some patients, especially
those who are not interested in implants and have some excess fat on their
tummy, flanks, or legs,” Dr.
Suber says. “The downside, however, is that it may take
several operations to reach the desired goal.”    

It’s important to note that while fat transfer
is a proven, legitimate way to increase breast volume, doctors advertising stem-cell
transfers for breast enlargement should be given some serious side-eye, according to the ASPS. In fact, based on a 2014
statement in the organization’s official medical journal, Plastic & Reconstructive Surgery, you’re probably just
paying more for a plain old fat transfer, or a mystery mixture. 

“Without advanced cell-sorting procedures, the products
used in these procedures likely contain many other types of cells besides
fat-derived stem cells,” the statement says. Furthermore, “many
clinics also offered plasma-rich platelet protein treatments, which they
inaccurately marketed as stem-cell therapy.”      

Temporary Saline Injections

Just like any elective surgery, breast augmentation is a very
personal and, in many cases, very difficult decision. However, a rare but buzzed-about
new technique is making the decision a little easier by showing women what they
could look like post-op. No, it’s not a 3-D rendering or implants worn
in your bra; it’s an injection that makes your breasts
larger for just 24 hours.    

Sounds like magic, doesn’t it? But, it’s actually a safe,
non-invasive, temporary medical procedure based on a tissue-expanding technique
used in many types of surgeries.     

Given the name InstaBreast by Norman Rowe, MD, the board-certified
plastic surgeon who claims to have invented the treatment, the breasts are
essentially inflated with simple saline solution over the course of about 20
minutes. This injected saline adds volume for about a day, and as it’s
safely absorbed by the body — and you pee out the extra salt water — breasts
go back to their original size.     

Dr. Rowe is also working on an injection that could last two to three weeks, so women can get a
better idea of what life would be like with larger breasts — or
just for the fun of it. He has yet to disclose what the injection will be made
of, though.    

Keep in mind, InstaBreast is not a cheap experiment. At $2,500,
it’s not much less expensive than the average long-term augmentation procedure, which is about $3,700.